title: Esophageal perforation and rupture: a comprehensive medicolegal examination of 59 jury verdicts and settlements.
abstract: BACKGROUND
  Consequences accompanying esophageal perforation make this complication a prime litigation target. We characterize factors in jury verdicts and settlements regarding esophageal perforation, including operative procedure, patient demographics, alleged cause(s) of malpractice, outcome, and other factors.
  
  
  METHODS
  Pertinent court records were examined for the aforementioned factors.
  
  
  RESULTS
  Gastroenterologists, general surgeons, and anesthesiologists were the most commonly named defendants. Two thirds of outcomes were for the defendant, and 11.9 % were settled (median--$650,000); 20.3% resulted in awarded damages (median--$1.2 M). Esophagogastroduodenoscopy was the most commonly litigated procedure, followed by intubation and Nissen fundoplication. Necessity of repair, delayed diagnosis, death, and inadequate consent were the most frequently cited factors in litigation.
  
  
  CONCLUSIONS
  An understanding of the factors important in determining legal responsibility is of great interest for practitioners in multiple specialties. The requirement of surgical repair and a delay in diagnosis are two of the most common factors present in litigated cases resulting in a payment. The importance of explicitly listing esophageal perforation in the informed consent for esophagogastroduodenoscopy, abdominal surgery, and any patients at risk of intubation injury needs to be emphasized.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.forename: Anna A
authors.initials: AA
authors.lastname: Pashkova
authors.forename: Gian-Paul
authors.initials: GP
authors.lastname: Vidal
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Mauro
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.forename: Ravi J
authors.initials: RJ
authors.lastname: Chokshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004939:Esophageal Perforation / Q000209:etiology*; D004947:Esophagus / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D012421:Rupture; D055815:Young Adult